Kancir C B, Madsen T, Petersen P H, Stokke D
Department of Anaesthesia, Odense University Hospital, Denmark.
Acta Anaesthesiol Scand. 1988 Nov;32(8):676-80. doi: 10.1111/j.1399-6576.1988.tb02807.x.
The plasma concentration variations of calcium, magnesium and phosphate were studied in ten patients during and after hypothermic cardiopulmonary bypass (CPB) without temperature correction of acid base status. During the study, pH remained stable, but all the other studied components varied significantly (P less than 0.001). At the start of CPB, the mean ionized calcium concentration increased 25%, and magnesium and phosphate decreased 29% and 40%, respectively, from their control values. At the end of blood cooling, ionized calcium was still 11% above its initial value, magnesium 50% above, and phosphate 39% below. Before weaning from CPB, ionized calcium remained 10% above its initial level, magnesium 41% above, and phosphate 26% below. After CPB, the different divalent ions returned to their initial levels within 1 h for ionized calcium, 6 h for phosphate and 9 h for magnesium. One day post-CPB, ionized calcium was at its start level, magnesium 13% lower, and phosphate 36% higher. During cardiac surgery, the acid base regulation without temperature correction (so-called "alpha stat mode") avoided the appearance of carbon dioxide acidosis. There were widespread disturbances of the divalent ions concentrations, due principally to the different fluids used during CPB, pump priming fluids and cardioplegic solution.
在十名患者进行低温体外循环（CPB）期间及之后，在不进行酸碱状态温度校正的情况下，研究了钙、镁和磷酸盐的血浆浓度变化。研究期间，pH值保持稳定，但所有其他研究成分均有显著变化（P<0.001）。在CPB开始时，平均离子钙浓度较对照值增加25%，镁和磷酸盐分别降低29%和40%。在血液降温结束时，离子钙仍比其初始值高11%，镁高50%，磷酸盐低39%。在CPB撤机前，离子钙比其初始水平高10%，镁高41%，磷酸盐低26%。CPB后，不同的二价离子在1小时内（离子钙）、6小时内（磷酸盐）和9小时内（镁）恢复到初始水平。CPB后一天，离子钙处于其开始水平，镁低13%，磷酸盐高36%。在心脏手术期间，不进行温度校正的酸碱调节（所谓的“α稳态模式”）避免了二氧化碳酸中毒的出现。二价离子浓度存在广泛紊乱，主要是由于CPB期间使用的不同液体、泵预充液和心脏停搏液。
